摘要
目的研究鼻咽癌患者IMRT和常规放射治疗前后腮腺功能变化以及随访中腮腺功能恢复程度。方法将35例鼻咽癌患者，分为IMRT组（26）例，年龄17-67岁，中位年龄41岁；男19例，女7例，鼻咽部GTV为6600-7230cGy，30-32次，6-7周。常规放射治疗组9例，年龄38-66岁，中位年龄47岁；男6例，女3例。鼻咽部DT7200cGy，36次，7-8周。计算腮腺分泌功能指标-最大酸反应泌^99mTcTcO4-率（Ex）。结果不论常规放疗或适形调强放疗，放疗结束时腮腺功能急性放射性损伤两组之间没有明显的差别，P=0.604。随访6个月以上，发现在IMRT组中腮腺功能损伤恢复情况大大好于常规放疗组，两组之间有显著性差异，P〈0.001。结论采用IMRT将腮腺剂量控制在26Gy以下，明显有利于腮腺功能的恢复。
Objective To study the parotid function with quantitative rtechnetate salivary scintigraphy prior to and after radiotherapy for patients with nasopharygeal carcinoma （NPC） and to analyze irradiatiom induced changes in relation to time interval following radical radiotherapy. Methods From April 2002 to April 2005, 35 histologically proven NPC patients were referred to receive radical radiotherapy. 26 patients were treated with IMRT （GTV 6 600 - 7 230 cGy/30 - 32fx/6 - 7w） and 9 patients with conventional radiotheraphy （tumor doses 7 200 cGy/36fx/7 - 8w） to the primary regions. The parotid scintigraphy was performed prior to radiotherapy and at the end of radiotherapy , and every 6 months for 3 years after radiotherapy. After intravenous administration of ^99M0^-99mTc - 370MBq/0.5ml, sequential-minute frames were acquired simultaneously. After 50 minutes, 200 mg of vitamin C were placed on the tongue to stimulate salivary excretion. Data were analyzed by computer and parameters including uptake rate （ UR）, excretion rate （ER） and excretion index （EI） were acquired, Results ER and EI decreased significantly after end of IMRT or conventional radiotheraphy. During the 3 years follow up period , obviously increase of ER and EI was observed. The ER and EI of IMRT were higher than those of conventional radiotheraphy more than 6 months after radiotherapy. Conclusion Parotid function decreased significantly after conventional radiotheraphy and IMRT and increase was observed during the 6 months follow up time. It would contribute to improve of the quality of life of the patients if the patient were accepted IMRT.
出处
《实用癌症杂志》
2007年第4期380-383,共4页
The Practical Journal of Cancer
基金
福建省卫生厅青年基金项目(课题编号:2001-1-24)
